Provider Demographics
NPI:1215970512
Name:BUTLER, CHRISTOPHER L (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:L
Last Name:BUTLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:297 NORTH ST STE 221
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-5133
Mailing Address - Country:US
Mailing Address - Phone:508-862-7777
Mailing Address - Fax:
Practice Address - Street 1:130 NORTH ST
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-3825
Practice Address - Country:US
Practice Address - Phone:508-778-4777
Practice Address - Fax:508-771-9555
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD028269E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
200727OtherUPMC HEALTH PLAN
P000248OtherGATEWAY HEALTH PLAN
459406OtherBLUE SHIELD
080172833OtherRAILROAD MEDICARE
4308190OtherAETNA
PA001038183Medicaid
C34365Medicare UPIN
PA001038183Medicaid
PA001038183Medicaid